Feasibility of Better Living After Stroke Through Technology
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 入组人数
- 7
- 试验地点
- 1
- 主要终点
- Activity Card Sort (change)
研究概览
简要总结
The investigators propose to evaluate the feasibility of Better Living After Stroke through Technology (BLAST) to help stroke survivors and family members return back to their productive and meaningful lives by proactively 1) helping them set their activity goals using ACS, 2) assessing their behavioral/functional capabilities using FBP, 3) recognizing symptoms indicative potential secondary stroke risks, 4) engaging support from online/community resources, and 5) offering tailored self-management recommendations using evidence-based strategies on how to achieve their activity goals and avoid secondary stroke based on their capabilities, stroke-related symptoms and available social resources.
详细描述
Stroke, which is the leading cause of disability, cognitive impairment and death in the US, imposes significant financial and personal burden. Although the residual effects of stroke affect many aspects of life, many aspects are not addressed by traditional rehabilitation treatments. In particular, persons with mild stroke, typically defined as a stroke with no or slight motor impairment and a high level of independence in basic activities of daily living, often experience emotional problems, subtle but significant cognitive impairment and decreased participation in productive, social and leisure activity. Despite these problems, persons with mild stroke are typically discharged to home without further referral to health or rehabilitation services other than follow-up with primary care physicians.
This application is in response to RFA PA-11-335 (Lab to Marketplace: Tools for Biomedical and Behavioral Research), a special 2-year Phase I SBIR program to accelerate the translation of behavioral research from academic to the marketplace. The project is based on the extensive research that developed and tested reliable and valid measures of activity participation (Activity Card Sort, or ACS) and cognitive skills supporting performance of simple and complex functional tasks (Functional Behavior Profile, or FBP). These measures have been used to guide treatments to help persons with mild cognitive impairment and their families support functional independence. These measures and the results of other studies will be used to build a dynamic online self-management tool designed to help persons with mild stroke develop individualized strategies that will support optimal recovery.
The investigators propose to evaluate the feasibility of Better Living After Stroke through Technology (BLAST) to help stroke survivors and family members return back to their productive and meaningful lives by proactively 1) helping them set their activity goals using ACS, 2) assessing their behavioral/functional capabilities using FBP, 3) recognizing symptoms indicative potential secondary stroke risks, 4) engaging support from online/community resources, and 5) offering tailored self-management recommendations using evidence-based strategies on how to achieve their activity goals and avoid secondary stroke based on their capabilities, stroke-related symptoms and available social resources.
Stroke survivors and family using the BLAST system are expected to have 1) better life satisfaction as measured by the Overall Recovery item of the Stroke Impact Scale; 2) increased activity as measured by Activity Card Sort; 3) better problem-solving and task performance as measured by Functional Behavior Profile; and 4) fewer caregiver concerns as measured by the Stroke Caregiver Needs Scale.
Specific Aims: 1) to evaluate the acceptability of BLAST ; and 2) to evaluate the preliminary effect of BLAST on self-efficacy, participation, and community reintegration.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 55 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •55 years of age and older
- •diagnosis of mild to moderate ischemic stroke (NIHSS <16)
- •3 months to 5 years post-stroke onset (of most recent stroke)
- •the availability of a willing caregiver or supportive individual throughout the intervention
- •access to a computer or tablet with internet access
- •discharged from the hospital to the community
- •able to read, write, and speak English fluently; and (8) community dwelling
排除标准
- •history of functional impairment prior to the index stroke as self-reported on the Telephone Screening Form
- •current diagnosis of a severe psychiatric disorder
- •current drug/alcohol abuse
- •terminal illness
- •Montreal Cognitive Assessment score of less than 23
- •direct verbal cue required for EFPTe test
- •severe depressive symptoms as indicated on the Patient Health Questionnaire (PHQ-9 score greater than 19)
- •any thoughts of harming themselves or others as indicated on question #9 of the PHQ-9.
研究组 & 干预措施
BLAST
All participants in this study will be assigned to this group to participate in the BLAST intervention. The intervention will be a self-guided web-based platform using a self-management model to help support better engagement in everyday life activity
干预措施: BLAST (Behavioral)
结局指标
主要结局
Activity Card Sort (change)
时间窗: Change from baseline score at 12 weeks (post-intervention)
records the activity participation and engagement of adults in instrumental, leisure and social activities currently and prior to a health event. Possible scores 0 - 32 where 32 indicates the most activity.
Participation Strategies Self-Efficacy Scale (change)
时间窗: Change from baseline score at 12 weeks (post-intervention)
35-item scale designed to assess self-efficacy in using participation strategies following a stroke using six subscales: (1) managing home participation, (2) staying organized, (3) planning and managing community participation, (4) managing work/productivity, (5) managing communication, and (6) advocating for resources, where higher scores equate to more self-efficacy.
After Scenario Questionnaire
时间窗: 12-weeks after baseline assessment (post-intervention)
assessment of acceptability of the intervention. Scale of 1 - 7 where 1 = lowest acceptability and 7 = most acceptability.
Patient-Reported Outcomes Measurement Information System (PROMIS)- 29 (change)
时间窗: Change from baseline score at 12 weeks (post-intervention)
generic health-related quality of life survey, assesses each of the 7 PROMIS domains: depression; anxiety; physical function; pain interference; fatigue; sleep disturbance; and ability to participate in social roles and activities. Scale of 1 - 5, where 1 = poorest quality of life and 5 = best quality of life.
Stroke Impact Scale (change)
时间窗: Change from baseline score at 12 weeks (post-intervention)
stroke-specific, self-report, health status measure. It was designed to assess multidimensional stroke outcomes, including strength, hand function Activities of Daily Living / Instrumental Activities of Daily Living, mobility, communication, emotion, memory and thinking, and participation. Total possible score = 59 - 295 where 295 = the least impact of stroke.
Post Study System Usability Questionnaire
时间窗: 12-weeks after baseline assessment (post-intervention)
assessment of participant satisfaction and evaluation of usability of the web-based platform. Scale of 1 - 7 where 1 = least satisfaction and 7 = most satisfaction.
次要结局
- Executive Function Performance Test- Enhanced (EFPTe) (change)(Change from baseline score at 12 weeks (post-intervention))
- Functional Behavior Profile (change)(Change from baseline score at 12 weeks (post-intervention))
- Patient Health Questionnaire (PHQ-9) (change)(Change from baseline score at 12 weeks (post-intervention))
- Lawton Instrumental Activities of Daily Life Scale (change)(Change from baseline score at 12 weeks (post-intervention))
- Reintegration to Normal Living Index/Scale (change)(Change from baseline score at 12 weeks (post-intervention))
研究者
Timothy J Wolf
Associate Professor, Occupational Therapy
University of Missouri-Columbia